Preventing the Train Wrecks of Tomorrow | Alberta Manga and Miranda Buder, Custom Design Benefits

In this episode of Care Beyond Code, we're joined by Alberta Manga and Miranda Buder from Custom Design Benefits. They discuss how their unique in-house medical management and patient advocacy teams use data to predict and prevent high-risk hospital admissions.Listen as they share two high-impact stories of real people navigating difficult diagnoses. Learn how Custom Design Benefits secured a single case agreement for out-of-network cancer care in just three hours to avoid surprise billing. Then, hear how they guided a patient through post-discharge financial anxiety by securing community resources and setting up a hospital payment plan.What you will learn:-- How in-house case management eliminates lagging data transfers to assist members immediately.-- Why looking at the social determinants of health is crucial for a successful patient recovery.-- How three-way calls can help laymen navigate complex hospital financial conversations.00:00 Welcome to Care Beyond Code00:46 Introduction to Custom Design Benefits01:45 The Advantage of In-House Medical Management03:21 Predicting and Preventing Future Health Crises05:04 Addressing Social Determinants of Health06:44 Story 1: A Testicular Cancer Diagnosis08:28 Securing an Out-of-Network Single Case Agreement11:15 Resolving Patient Frustration in Just Three Hours15:04 Building Long-Term Trust with Patients16:25 Story 2: Recovering from a Ruptured Appendix17:27 Providing Community Resources for Financial Anxiety20:44 Navigating Hospital Payment Plans via Three-Way Calls22:24 The Importance of Compassionate Healthcare Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech.